Безопасно. Совместимый. Минимальный риск для грудного вскармливания и ребёнка.
Антидепрессант СИОЗС с действиями и использованием, подобными флуоксетину. S-энантиомер циталопрама, который имеет сходную фармакокинетику с циталопрамом. Пероральное введение один раз в день.
Он выделяется с грудным молоком в небольших количествах (Weisskopf 2020 y 2017, Delaney 2018, Hackett 2006, Rampono 2006, Castberg 2006).
Было показано, что уровни в сыворотке младенцев от кормящих матерей, которые лечились, не поддавались обнаружению или были очень низкими. (Delaney 2018, Rampono 2006)
В целом не было зарегистрировано краткосрочного или долгосрочного вредного воздействия на детей, находящихся на грудном вскармливании (Hackett 2006, Gentile 2006, Rampono 2006, Castberg 2006). В медицинской литературе описаны отдельные случаи раздражительности, сонливости (Kronenfeld, 2018), неонатального некротизирующего энтероколита (Potts, 2007) или судорог (Neuman, 2014) после внутриутробного воздействия и/или политерапии, в отличие от безвредности, о которой сообщают другие.
Может появиться галакторея, связанная или не связанная с гиперпролактинемией. (McGrane 2019, Pathania 2018, Suthar 2018, Kaba 2017, Shim 2009, Gulsun 2007)
Несколько медицинских обществ, эксперты и эксперты считают использование этого лекарства безопасным или, вероятно, безопасным во время грудного вскармливания. (Hale, Lactmed, Uguz 2021, Weisskopf 2020, Davanzo 2014 y 2011, Rowe 2013, Bellantuono 2013 y 2012, Berle 2011, Amir 2011)
Более безопасные известные альтернативы могут быть предпочтительнее, особенно в неонатальный период и в случаях недоношенности. (Orsolini 2015, Sriraman 2015, Patil 2011)
Женщины, страдающие депрессией во время беременности, нуждаются в большей поддержке грудного вскармливания из-за повышенного риска проблем с грудным вскармливанием и раннего отлучения от груди. (Grzeskowiak 2018, Leggett 2017, Gorman 2012)
| Наименование | Значение | Ед.изм. |
|---|---|---|
| pKa | 9.8 | моль/л |
| Tmax | 4 - 5 | час |
| T½ | 30 | час |
| БПП | 80 | % |
| Молекулярная масса | 414 | Да |
| ОР | 12 - 26 | л/кг |
| Относительная доза | 1.7 - 9 | % |
| Связывание с белками | 56 | % |
| Соотношение М/П | 1.7 - 2.5 | - |
| Теоретическая доза | 0.004 - 0.01 | мг/кг/сут |
См. ниже информацию об этих сопутствующих препаратах:
Депрессия у кормящей матери ◐ Умеренный риск
Альтернативы:
Автор: LactMed.
Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/
2006 -
Автор: Hale TW.
Medications & Mothers' Milk.
1991- . Springer Publishing Company. Available from https://www.halesmeds.com
Автор: Uguz F.
A New Safety Scoring System for the Use of Psychotropic Drugs During Lactation.
Am J Ther. 2021 Jan-Feb 01;28(1):e118-e126.
Автор: Weisskopf E, Guidi M, Fischer CJ, Bickle Graz M, Beaufils E, Nguyen KA, Morisod Harari M, Rouiller S, Rothenburger S, Gaucherand P, Kassai-Koupai B, Borradori Tolsa C, Epiney M, Tolsa JF, Vial Y, Hascoët JM, Claris O, Eap CB, Panchaud A, Csajka C.
A population pharmacokinetic model for escitalopram and its major metabolite in depressive patients during the perinatal period: Prediction of infant drug exposure through breast milk.
Br J Clin Pharmacol. 2020 Aug;86(8):1642-1653.
Автор: McGrane IR, Morefield CM, Aytes KL.
Probable Galactorrhea Associated with Sequential Trials of Escitalopram and Duloxetine in an Adolescent Female.
J Child Adolesc Psychopharmacol. 2019 Dec;29(10):788-789.
Автор: Suthar N, Pareek V, Nebhinani N, Suman DK.
Galactorrhea with antidepressants: A case series.
Indian J Psychiatry. 2018 Jan-Mar;60(1):145-146.
Автор: Pathania M, Goel B, Dhamija P, Kant R, Dhar M, Mittal S.
A rare adverse drug reaction to escitalopram.
J Family Med Prim Care. 2018 Mar-Apr;7(2):466-467.
Автор: Kronenfeld N, Ziv Baran T, Berlin M, Karra N, Dinavitser N, Cohen R, Wiener Y, Schwartzberg E, Berkovitch M.
Chronic use of psychotropic medications in breastfeeding women: Is it safe?
PLoS One. 2018 May 21;13(5):e0197196.
Автор: Delaney SR, Malik PRV, Stefan C, Edginton AN, Colantonio DA, Ito S.
Predicting Escitalopram Exposure to Breastfeeding Infants: Integrating Analytical and In Silico Techniques.
Clin Pharmacokinet. 2018 Dec;57(12):1603-1611.
Автор: Grzeskowiak LE, Leggett C, Costi L, Roberts CT, Amir LH.
Impact of serotonin reuptake inhibitor use on breast milk supply in mothers of preterm infants: a retrospective cohort study.
Br J Clin Pharmacol. 2018 Jun;84(6):1373-1379.
Автор: Kaba D, Öner Ö.
Galactorrhea After Selective Serotonin Reuptake Inhibitor Use in an Adolescent Girl: A Case Report.
J Clin Psychopharmacol. 2017 Jun;37(3):374-376.
Автор: Weisskopf E, Panchaud A, Nguyen KA, Grosjean D, Hascoët JM, Csajka C, Eap CB, Ansermot N; collaborators of the SSRI-Breast Milk study..
Simultaneous determination of selective serotonin reuptake inhibitors and their main metabolites in human breast milk by liquid chromatography-electrospray mass spectrometry.
J Chromatogr B Analyt Technol Biomed Life Sci. 2017 Jul 1;1057:101-109.
Автор: Venkatesh KK, Castro VM, Perlis RH, Kaimal AJ.
Impact of antidepressant treatment during pregnancy on obstetric outcomes among women previously treated for depression: an observational cohort study.
J Perinatol. 2017 Sep;37(9):1003-1009.
Автор: Leggett C, Costi L, Morrison JL, Clifton VL, Grzeskowiak LE.
Antidepressant Use in Late Gestation and Breastfeeding Rates at Discharge from Hospital.
J Hum Lact. 2017 Nov;33(4):701-709.
Автор: Orsolini L, Bellantuono C.
Serotonin reuptake inhibitors and breastfeeding: a systematic review.
Hum Psychopharmacol. 2015 Jan;30(1):4-20.
Автор: Sriraman NK, Melvin K, Meltzer-Brody S.
ABM Clinical Protocol #18: Use of Antidepressants in Breastfeeding Mothers.
Breastfeed Med.
Автор: Davanzo R, Bua J, Paloni G, Facchina G.
Breastfeeding and migraine drugs.
Eur J Clin Pharmacol.
Автор: Neuman G, Colantonio D, Delaney S, Szynkaruk M, Ito S.
Bupropion and Escitalopram During Lactation.
Ann Pharmacother.
Автор: Bellantuono C, Orsolini L, Bozzi F.
[The safety profile of escitalopram in pregnancy and breastfeeding].
Riv Psichiatr.
Автор: Bellantuono C, Bozzi F, Orsolini L.
Safety of escitalopram in pregnancy: a case series.
Neuropsychiatr Dis Treat.
Автор: Rowe H, Baker T, Hale TW.
Maternal medication, drug use, and breastfeeding.
Pediatr Clin North Am. 2013 Feb;60(1):275-94.
Автор: Bellantuono C, Bozzi F, Orsolini L, Catena-Dell'Osso M.
The safety of escitalopram during pregnancy and breastfeeding: a comprehensive review.
Hum Psychopharmacol.
Автор: Gorman JR, Kao K, Chambers CD.
Breastfeeding among women exposed to antidepressants during pregnancy.
J Hum Lact.
Автор: Patil AS, Kuller JA, Rhee EH.
Antidepressants in pregnancy: a review of commonly prescribed medications.
Obstet Gynecol Surv.
Автор: Berle JO, Spigset O.
Antidepressant Use During Breastfeeding.
Curr Womens Health Rev.
Автор: Davanzo R, Copertino M, De Cunto A, Minen F, Amaddeo A.
Antidepressant drugs and breastfeeding: a review of the literature.
Breastfeed Med.
Автор: Amir LH, Pirotta MV, Raval M.
Breastfeeding--evidence based guidelines for the use of medicines.
Aust Fam Physician. 2011 Sep;40(9):684-90. Review.
Автор: Lanza di Scalea T, Wisner KL.
Antidepressant medication use during breastfeeding.
Clin Obstet Gynecol.
Автор: Shim SH, Lee YJ, Lee EC.
A case of galactorrhea associated with excitalopram.
Psychiatry Investig.
Автор: Potts AL, Young KL, Carter BS, Shenai JP.
Necrotizing enterocolitis associated with in utero and breast milk exposure to the selective serotonin reuptake inhibitor, escitalopram.
J Perinatol.
Автор: Gulsun M, Algul A, Semiz UB, Ates MA, Doruk A, Ebrinc S, Basoglu C, Cetin M.
A case with euprolactinemic galactorrhea induced by escitalopram.
Int J Psychiatry Med.
Автор: Hackett LP, Ilett KF, Rampono J, Kristensen JH, Kohan R.
Transfer of reboxetine into breastmilk, its plasma concentrations and lack of adverse effects in the breastfed infant.
Eur J Clin Pharmacol.
Автор: Gentile S.
Escitalopram late in pregnancy and while breast-feeding.
Ann Pharmacother.
Автор: Rampono J, Hackett LP, Kristensen JH, Kohan R, Page-Sharp M, Ilett KF.
Transfer of escitalopram and its metabolite demethylescitalopram into breastmilk.
Br J Clin Pharmacol.
Автор: Castberg I, Spigset O.
Excretion of escitalopram in breast milk.
J Clin Psychopharmacol.
Автор: Castberg I, Spigset O.
Excretion of escitalopram in breast milk.
J Clin Psychopharmacol.
Автор: Gulsun M, Algul A, Semiz UB, Ates MA, Doruk A, Ebrinc S, Basoglu C, Cetin M.
A case with euprolactinemic galactorrhea induced by escitalopram.
Int J Psychiatry Med.
Автор: Hackett LP, Ilett KF, Rampono J, Kristensen JH, Kohan R.
Transfer of reboxetine into breastmilk, its plasma concentrations and lack of adverse effects in the breastfed infant.
Eur J Clin Pharmacol.
Автор: Gentile S.
Escitalopram late in pregnancy and while breast-feeding.
Ann Pharmacother.
Автор: Rampono J, Hackett LP, Kristensen JH, Kohan R, Page-Sharp M, Ilett KF.
Transfer of escitalopram and its metabolite demethylescitalopram into breastmilk.
Br J Clin Pharmacol.
Автор: Potts AL, Young KL, Carter BS, Shenai JP.
Necrotizing enterocolitis associated with in utero and breast milk exposure to the selective serotonin reuptake inhibitor, escitalopram.
J Perinatol.
Автор: Rowe H, Baker T, Hale TW.
Maternal medication, drug use, and breastfeeding.
Pediatr Clin North Am. 2013 Feb;60(1):275-94.
Автор: Bellantuono C, Bozzi F, Orsolini L, Catena-Dell'Osso M.
The safety of escitalopram during pregnancy and breastfeeding: a comprehensive review.
Hum Psychopharmacol.
Автор: Gorman JR, Kao K, Chambers CD.
Breastfeeding among women exposed to antidepressants during pregnancy.
J Hum Lact.
Автор: Patil AS, Kuller JA, Rhee EH.
Antidepressants in pregnancy: a review of commonly prescribed medications.
Obstet Gynecol Surv.
Автор: Berle JO, Spigset O.
Antidepressant Use During Breastfeeding.
Curr Womens Health Rev.
Автор: Davanzo R, Copertino M, De Cunto A, Minen F, Amaddeo A.
Antidepressant drugs and breastfeeding: a review of the literature.
Breastfeed Med.
Автор: Amir LH, Pirotta MV, Raval M.
Breastfeeding--evidence based guidelines for the use of medicines.
Aust Fam Physician. 2011 Sep;40(9):684-90. Review.
Автор: Lanza di Scalea T, Wisner KL.
Antidepressant medication use during breastfeeding.
Clin Obstet Gynecol.
Автор: Shim SH, Lee YJ, Lee EC.
A case of galactorrhea associated with excitalopram.
Psychiatry Investig.
Автор: LactMed.
Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/
2006 -
Автор: Hale TW.
Medications & Mothers' Milk.
1991- . Springer Publishing Company. Available from https://www.halesmeds.com
Автор: Uguz F.
A New Safety Scoring System for the Use of Psychotropic Drugs During Lactation.
Am J Ther. 2021 Jan-Feb 01;28(1):e118-e126.
Автор: Weisskopf E, Guidi M, Fischer CJ, Bickle Graz M, Beaufils E, Nguyen KA, Morisod Harari M, Rouiller S, Rothenburger S, Gaucherand P, Kassai-Koupai B, Borradori Tolsa C, Epiney M, Tolsa JF, Vial Y, Hascoët JM, Claris O, Eap CB, Panchaud A, Csajka C.
A population pharmacokinetic model for escitalopram and its major metabolite in depressive patients during the perinatal period: Prediction of infant drug exposure through breast milk.
Br J Clin Pharmacol. 2020 Aug;86(8):1642-1653.
Автор: McGrane IR, Morefield CM, Aytes KL.
Probable Galactorrhea Associated with Sequential Trials of Escitalopram and Duloxetine in an Adolescent Female.
J Child Adolesc Psychopharmacol. 2019 Dec;29(10):788-789.
Автор: Suthar N, Pareek V, Nebhinani N, Suman DK.
Galactorrhea with antidepressants: A case series.
Indian J Psychiatry. 2018 Jan-Mar;60(1):145-146.
Автор: Pathania M, Goel B, Dhamija P, Kant R, Dhar M, Mittal S.
A rare adverse drug reaction to escitalopram.
J Family Med Prim Care. 2018 Mar-Apr;7(2):466-467.
Автор: Kronenfeld N, Ziv Baran T, Berlin M, Karra N, Dinavitser N, Cohen R, Wiener Y, Schwartzberg E, Berkovitch M.
Chronic use of psychotropic medications in breastfeeding women: Is it safe?
PLoS One. 2018 May 21;13(5):e0197196.
Автор: Delaney SR, Malik PRV, Stefan C, Edginton AN, Colantonio DA, Ito S.
Predicting Escitalopram Exposure to Breastfeeding Infants: Integrating Analytical and In Silico Techniques.
Clin Pharmacokinet. 2018 Dec;57(12):1603-1611.
Автор: Grzeskowiak LE, Leggett C, Costi L, Roberts CT, Amir LH.
Impact of serotonin reuptake inhibitor use on breast milk supply in mothers of preterm infants: a retrospective cohort study.
Br J Clin Pharmacol. 2018 Jun;84(6):1373-1379.
Автор: Kaba D, Öner Ö.
Galactorrhea After Selective Serotonin Reuptake Inhibitor Use in an Adolescent Girl: A Case Report.
J Clin Psychopharmacol. 2017 Jun;37(3):374-376.
Автор: Weisskopf E, Panchaud A, Nguyen KA, Grosjean D, Hascoët JM, Csajka C, Eap CB, Ansermot N; collaborators of the SSRI-Breast Milk study..
Simultaneous determination of selective serotonin reuptake inhibitors and their main metabolites in human breast milk by liquid chromatography-electrospray mass spectrometry.
J Chromatogr B Analyt Technol Biomed Life Sci. 2017 Jul 1;1057:101-109.
Автор: Venkatesh KK, Castro VM, Perlis RH, Kaimal AJ.
Impact of antidepressant treatment during pregnancy on obstetric outcomes among women previously treated for depression: an observational cohort study.
J Perinatol. 2017 Sep;37(9):1003-1009.
Автор: Leggett C, Costi L, Morrison JL, Clifton VL, Grzeskowiak LE.
Antidepressant Use in Late Gestation and Breastfeeding Rates at Discharge from Hospital.
J Hum Lact. 2017 Nov;33(4):701-709.
Автор: Orsolini L, Bellantuono C.
Serotonin reuptake inhibitors and breastfeeding: a systematic review.
Hum Psychopharmacol. 2015 Jan;30(1):4-20.
Автор: Sriraman NK, Melvin K, Meltzer-Brody S.
ABM Clinical Protocol #18: Use of Antidepressants in Breastfeeding Mothers.
Breastfeed Med.
Автор: Davanzo R, Bua J, Paloni G, Facchina G.
Breastfeeding and migraine drugs.
Eur J Clin Pharmacol.
Автор: Neuman G, Colantonio D, Delaney S, Szynkaruk M, Ito S.
Bupropion and Escitalopram During Lactation.
Ann Pharmacother.
Автор: Bellantuono C, Orsolini L, Bozzi F.
[The safety profile of escitalopram in pregnancy and breastfeeding].
Riv Psichiatr.
Автор: Bellantuono C, Bozzi F, Orsolini L.
Safety of escitalopram in pregnancy: a case series.
Neuropsychiatr Dis Treat.
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